Symptoms and risk factors for long COVID in non-hospitalized adults

The study, using a UK-based primary care database, investigated long COVID symptoms and risk factors in non-hospitalized adults. It involved 486,149 adults with confirmed SARS-CoV-2 infection and 1,944,580 matched adults without recorded SARS-CoV-2 infection. The study identified 62 symptoms significantly associated with SARS-CoV-2 infection after 12 weeks, with the most notable being anosmia, hair loss, sneezing, ejaculation difficulty, and reduced libido.

Key findings of the study include:

  1. Persistent Symptoms: SARS-CoV-2 infection was associated with a wide range of symptoms persisting beyond 12 weeks. These included commonly recognized symptoms like anosmia, shortness of breath, chest pain, and fever, as well as less commonly reported symptoms like hair loss and sexual dysfunction.
  2. Risk Factors for Long COVID: Several sociodemographic and clinical factors were significantly associated with the incidence of long COVID. Women, individuals from ethnic minority groups, people experiencing socioeconomic deprivation, smokers, those with a high BMI, and a wide range of comorbidities (such as COPD, anxiety, and depression) were at increased risk. Interestingly, a gradient of decreasing age was associated with an increased risk of developing long COVID.
  3. Symptom Clusters: Among patients with SARS-CoV-2 infection and persistent symptoms, three major clusters were identified:
    • Class 1 (80%): Dominated by a broad spectrum of symptoms including pain, fatigue, and rash.
    • Class 2 (5.8%): Characterized by respiratory symptoms like cough, shortness of breath, and phlegm.
    • Class 3 (14.2%): Focused on mental health and cognitive symptoms such as anxiety, depression, insomnia, and brain fog.
  4. Relative Increase in Risk: SARS-CoV-2 infection was associated with a 26% relative increase in the risk of reporting at least one of the symptoms included in the WHO case definition for long COVID​​.

Overall, the study underscores the complexity and heterogeneity of long COVID, highlighting a broad spectrum of symptoms and the influence of various risk factors. This information is crucial for understanding the long-term effects of COVID-19 and guiding healthcare responses to address the diverse needs of affected individuals.

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